2014 Brain Awareness Night by Dr. Clancy Blair, Ph.D.: Wired for Learning - Early Brain Development and Life Success

Dr. Clancy Blair, Ph.D.
Department of Applied Psychology
Steinhardt School of Culture, Education, and Human Development
New York University

“Wired for Learning: Early Brain Development and Life Success”

Thursday, March 21, 2014

Transcript

Dr. Clancy Blair: Good. Can everyone here me? Thank you for being here on this evening. It's great. Thank you for the invitation to have me come. Let me just make sure I know how to work the slides. Yes I do. Good.

So, what I have to say will be a little bit, I think, redundant with what Nathan talked to you about. Now let me if I can make this bigger though, I'm sorry I can't see my slides here in this mode. Sorry I'm gonna have to...

You couldn't figure out how to do that, okay well if Nathan couldn't figure it out then I'm... well... okay... let me give it one.

Female Audience Member: Is it on presenter view?

Dr. Clancy Blair: It is on presenter view but the . . .

Female Audience Member: [inaudible 00:00:40].

Dr. Clancy Blair: Yeah that's what I was doing there. Tell you what... good enough. It will be a little bit redundant I think but hopefully not too... or some good built-in redundancy might be helpful... in covering this ground again, and making sense of it all, and thinking about children's development and the development of children's brains.

So are people familiar with brain training, working memory training? You may see these games on-line, Nintendo has them, Lumosity. You know, all of these things... life is brain training, right?

The brain is responding to experiences Nathan... as Professor Fox pointed out and developing very early, right from the start. And in ways that are appropriate for the environment in which development is occurring. Right? And so we need to keep that in mind. I think just that simple statement is just worth pondering over, right? So the brain is gonna to develop in response to experience in ways that are appropriate for the context in which the brain is situated, right? In response to experience over time.

And so when we know that children are growing up in adverse environments it's going to have effects on the brain. It's going to have effects on behavior that are appropriate for that context. However, that may not match with sort of are general goals for children, as we think about these general things, right? We know that the effects of experiences, as we heard before, the effects of parenting and family, effects of neighborhoods, schools and communities. And this idea here that the way in which the context in child development takes place will really shape development over time.

And so we've learned a lot about that. I want to share some of that with you and talk a little bit about the research that my colleagues and I have been doing, studying this idea that the brain, which we're really looking at through physiology more than so directly looking at the brain through EEG or MRI. But making an inference about the brain from the development of cognition and some other indicators, right? And so, this idea that, we can understand this, we have begun to understand this process quite well. And that has implications for the kinds of experiences we want to try to provide children to recover from adverse experience. And try to understand the limits of plasticity and malleability. That was a great question that we had before.

So, what are these sort of general goals for children? I think one way to think about these general goals is through this term self-regulation, right? So we want kids to be able to take initiative, right? And get out there and go. But also to be compliant when we need them to, right? We want them to be emotionally exuberant and expressive, and engaged, but then to be able to stop when we ask them to, right? That's a very important skill. We know that as teachers and parents. We experience that all the time. And to sustain attention and to focus but then stop doing that. Go play, go do something else. Go be rambunctious. Those sorts of things. And to interact socially with other children and adults, right? And to be conscientious. And to become focused in their activities. And really we can lump these under the sort of self-regulation idea. It's more than just self-control. It's more than just the ability to stop doing something and be compliant, but to understand it, right? Those are our goals for children. To be willing partners in a association with us. As their parents, as adults, as their friends, as their teachers, and so on and so forth.

So what is this self-regulation and how does it develop. Well we've learned quite a bit about that, right? At first it emerges of course, from other regulation. From warm sensitive interactions with caregivers. Those are essential as Professor Fox pointed out. The serve and return. It has to be there. And we see that these, you know, these are actually nice examples here. I just pulled them off Google, you know, images. But, we've got the loving, we've got the interchange there, we have the sort of watchful scaffolding in the lower... well your left-hand corner. And here dads are important too. We can't forget about that, right? There in there also. But these warm sensitive interactions, what they're providing children, they're helping children regulate, right? Parents help children regulate body temperature. Physiology, feeding, right? Sleeping. Those sorts of things. Those are foundational. From that you're gonna build to other, regulating emotion, regulating attention, right? Those are very, very important things. Joined attention, scaffolded attention, is what's going on here. It's moving away from that basic physiological regulation... regulating temperature, body, sleep, and so on and so forth, to more regulation of emotion and regulation of attention. And that's very important, right? Because the regulation of attention and emotion and physiology set the stage for the development of these executive functions that we've been talking about.

So, children of course, we know right from the get-go are paying attention, right? So infant attention is a fascinating window into childrens' development, right? And it's very interesting. You may be familiar with this research, right? This is called this violation of expectation paradigm. So, the idea here is what'll happen is, the child will be attending, and children will look longer, infants will look longer at novel events, things that are new, right? You show them something, a pattern or something, infants will habituate to it. You put a new one up, they'll spend more time looking at the new one than at the old one. It's just sort of novelty preference. It's a great thing.

Well some enterprising child development researchers realized they could make hay with this paradigm. And so what they did was they presented children expected and unexpected events. And this is a mathematics one, right? So, the hand comes in and puts an object in the case. The screen comes up. I'm focusing on the top one. A second objects added, and then the hand leaves empty. So what... how many things should be behind there, when the screen goes down? There should be two there. Did everybody follow me on that? Simple math. We got it, right? But if you have a confederate under the table, which is what psychologists like to do, right? They'll hang out under the table and take one away just to, you know, just to mess with you. And so when they do that and they mess with the child the screen comes down there's only one, children will reliably... at three months of age, at six months of age, look reliably longer at that unexpected event. That shouldn't be that way. What is that? Why is there only one there? And so... as you can imagine once we found this out, researchers have done this again, and again, and again. With math, with physical objects, physical properties.

And the idea, we don't know exactly what's going on. But, is it the infants reasoning about this stuff? No. The infants not reasoning about it. But the brain is tuning in to regularities. It's tuning in to regularities. As the brain learns language, it's tuning in to regularities, statistical probabilities. It's what the brain is doing early on. And so we can see that attention is going to be so very important as we seem to be... oh I missed my little gag. The slide comes up. It's as if the child is surprised by this event. Of course surprise it's a complicated emotion. You know, we don't want to say that children at that age necessarily are surprised by these things. But the violation of expectation is powerful. It clues us in to the importance of attention and that children are attending up-and-running early in life. And that's certainly a central goal of early care, is to scaffold and support childrens' attention. The other thing is to scaffold and support childrens' ability to regulate their emotion. Because this is the other system that's up-and-running right from the start, right? It's the main form of communication in infancy, is through emotion and emotional responses. And children have ways of regulating their emotions on their own, but they need support for that as well. So we have some again, from Google image.

Some nice examples of this with self-soothing, proximity to the caregiver, the mother, or with a plush toy here, right? An unregulated emotion can be... can lead to problems with attention, can lead to problems with physiology. If children don't learn to regulate emotion. So regulating attention, regulating emotion are fundamental building blocks for self-regulation. For becoming an active, purposeful, intentional little being that we talked about at the beginning with the goals for childrens' development.

And then finally there's of course a physiological substrate, and this is where the brain-part starts to creep in, right? So we're looking at attention, we're looking at emotion, and what happens when you have an emotional response. You become very interested in something. What does your heart do? It beats a little faster, right? Your breathing, maybe respiration increases, so on and so forth, it continues for a time, your hypotholamic pituitary adrenal axis will kick in. That's not a bad thing, right? Your HPA axis will kick in. So these stress hormones, which will be produced. And stress, not as a bad word, or not something to be avoided, but under moderate stress, mild stress, these stress hormones will kick in. So regulating attention, regulating emotion, regulating stress physiology. Super important because of everything that Professor Fox told you about the effects of these stress hormones on the brain and on brain development. They are a fundamental neural modulator, right? They will effect activity in the brain. And they will effect the way the brain wires up in response to experience over time.

So if an infant, a young child is in a caregiving relationship in which it's getting support... he or she is getting support for the regulation of emotion and the regulation of attention. There will be a physiological regulation that goes along with it. And the idea is that the brain will begin to wire up in response to this process of self regulation. The system will become a self-regulating system. But, if the child is under adverse circumstances, and adverse conditions, those stress hormones may rise to levels that are really uncoupled from attention and really uncoupled from emotion and can rise to levels in which they'll start to preferentially, shape their brain to make it more reactive, and less reflective or responsive to stimulation.

And that's the idea. That's what we're thinking about when we say early experience is helping set the stage for executive function development. So the executive functions are associated with pre-frontal cortex here, right, above the eyebrows, behind the forehead. This is a slower developing part of the brain. And the idea is that progress in physiological, emotional, attentional development should be good indicators of executive function development. And guess what, they really are. We have a lot of data to suggest this. So these executive functions, as we know, are working memory, inhibitory control, they're reflective capacity, the ability to reflect on experience, hold multiple things in mind, right? To inhibit, but to understand the reason for inhibiting or resisting distraction, so on and so forth.

As we know, they're very important for school readiness. In fact, I like to say that really executive functions and self-regulation, that is school readiness, right? Why do kids start school around age 6, age 5, age 6? Because the prefrontal cortex is maturing enough to control attention, to control emotional responses. Ask a kindergarten teacher what he or she wants to see in a child, it's that. Control your behavior. Sit still. Pay attention. Be curious. Be enthusiastic. Use your words, use language. Those sorts of things are very important and that's what kindergarten teachers say with this. So the idea here is that when we're talking about self-regulation, we're talking about the development of this system. Relations among physiological aspects of experience, emotional, attentional, cognitive aspects of experience. These are all integrated now. As we heard before, we used to study them separately and that's no fun. We want to study how they go together, how they develop together over time in response to experience.

It's very helpful, right? And as I said, the executive functions include this working memory, so on and so forth. We don't need to go over that anymore, but they're important for planning and problem solving, but also important for regulating emotion. Now there are many ways in which we regulate emotions, but certainly executive function is being able to distract ourselves to move our attention away from something that's bothering us. To use strategies, those sorts of things are very important and that's what we try to convey to children, right? Stop thinking about it. Stop doing that. Get away from there. Those sorts of things in the way we want to help children with this process.

So let me just show you, I think the best way to learn about executive functions if you're less familiar with it is to do some executive function task yourself, right? That's very helpful. So you can imagine this, we can all do it as a group if we want, but this is a very simple one developed by a psychologist in the Soviet Union, Alexandra Luria, who's a godfather of neuro-psychology basically. He was study largely veterans returning from the second World War. The soldiers of Russia who had gone and fought and defeated Hitler's armies. They're coming back and of course seeing traumatic brain injury in many of these soldiers and soldiers with damage to prefrontal cortex were unable to do this very simple task. It's Luria's peg tapping task. It's a very good assessment of prefrontal cortex function and executive function and it's quite simply when I tap one time, you tap two times. Okay? And when I tap two times, you tap one time, got it? So if we did that, if I tap one time, you tap two times. I tap two times, okay? Ready? Okay. You blew it. Out of the pool. It's a great task that way. It works very well. No three year old can do this one.

Really, basically all five year olds can except for you, right? And so in that way, it's really good around age four, age four and a half, they'll hang in there with you for a little while. They'll do some of the early taps, but then it's just like the rule evaporates. And you look at them and they're just tapping right back at you. Yeah. Okay. Great. Good job. You're working really hard at doing my peg tapping task, right?

So this is a good one for that. That's the sort of working memory and inhibitory control. You need to hold on to the rule and then execute, and that's the idea with working memory. I think this works so well because it's motoric and it's auditory. You hear that tap one time, you're just going to tap. Imitation is going to kick in and you need to resist that is the thing that's most important for this type of task. And then another one that we use, this was developed by Phil Zelazo and his student Sophie Jacques.

Phil is a professor at the University of Minnesota developed a very nice executive function measure for young children called the Dimension Change Card Sort. It's the work horse measure, really, of executive function for four year olds. This is like this. It says here show me two things that are alike on this page. Show me two things that go together. Most invariably, kids will point to the two teapots. It's really salient. There are two teapots there. That's right. That's good. Those things are alike. Those things go together.

Now show me two things that are alike on this page, but in a different way. Show me two things that are alike in a new way. And the idea here is you need a shift from the dimension of shape to the dimension of, thank you, good. So we go through about sixteen trials like this. This is the sort of flexibility, that's the kind of cognitive flexibility, attention shift. So these are a perfect measure or markers of what we want to see in children. But they're really good indicators of sort of the progress of prefrontal cortex development is what we think. And they're responsive to emotion and stress. So executive function is a tricky thing to measure because if you didn't sleep well or you're angry or if you get a child out of a classroom and he was just in an argument with someone, not having the best day, not going to do very well on executive function tasks. We come back tomorrow and he's had a good night's sleep and he's doing great, he's going to do a lot better, she's going to do a lot better on executive function tests. So the retest reliability of these things is tricky, but it's an important consideration because it's such an important skill I think and such a sort of good indicator.

But I think in many ways it's like the canary in the coal mine, right? We want to check in on kid's attention. We want to check in on their emotional development. We want to check in on their physiological development for the reasons that these will support executive functions over time.

But we need to understand, sometimes those executive functions aren't going to be there. We've all been around young children on bad days; they're just not going to be there. But we want to maximize the good days and the ability to begin to regulate that physiology attention in ways that support rather than undercut executive functions, right? So here's another one. This is just sort of a working memory task. It's hold on to two pieces of information. What color's in this house? What animal's in this house? What color? What animal? What color? What animal? So on and so forth.

So we can increase that so those tasks I talked to you about before, they work well with four year olds but threes can't do them and five year olds can. We want something that's scalable so that we can measure executive functions longitudinally. Use each person as his or her own control and longitudinal research to chart progress. This is the kind of task that we're using to do that. You might just be interested to know that if we make the dog blue and the bird red, it's a much harder task. Kids have much more difficulty separating. It's called binding the stimulus property. So a little bit of psychological trivia wisdom for you on that. So the idea is of course that these executive functions are associated with prefrontal cortex, and they're dependent on action, in vivo, dependent on levels of moderate increases in stress hormones, primarily norepinephrine and dopamine, but also glucocorticoid hormone cortisol, right? And that's to do with the receptors in this area of the brain and it will actually cause synaptic long-term potentiation. So it will get the cells to fire and they'll connect to the cells that they're adjacent to and they'll begin to wire up if there's a moderate amount of stimulation. A moderate amount of increase in norepinephrine or dopamine. But if it's too high, it will actually shut the process down. It will shut the synaptic activity down.

It will be synaptic long-term depression instead of potentiation. And this is the work of Amy Arnsten and Patricia Goldman who teach at Yale University. They've shown this in non-human primates doing single unit recording of neurons in the prefrontal cortex. This is very interesting. The analogy is loosely like an internal combustion engine. Our cars are idiot proof now, but those of us old enough will remember if you pushed the gas too hard in your car, you got too much gasoline in the cylinder head, it wouldn't fire. You flooded your engine out, right? You needed the exact right mixture of air and gas for it to ignite in the cylinder head. Kind of the same thing in your prefrontal cortex when you talk about dopamine, levels of dopamine, levels of norepinephrine. So we're very interested in children's ability to regulate emotionally, attentionally, and physiologically because of this idea. This is the basis for understanding the development of prefrontal cortex and the relation of brain development to behavior. Brain development to behavior. Essentially, we're just talking about this circuitry here. So this circuitry here, I don't have a pointer, but if you're familiar with your brain anatomy in the bottom there, the blue structures, the amygdala and hippocampus right behind that, this experience is registered very rapidly there, right? Preconsciously.

And when experience is registered there it produces this cascade of stress physiology, autonomic outflow, heart rate, increased heart rate and kicking in the HPA axis. But at the same time, it's producing through corticotropin releasing hormone, increases in norepinephrine and dopamine that feed forward through that red structure, the anterior singulate cortex to prefrontal cortex saying something's going on here. Should we engage executive functions? Yes, we should. It will feed back on and try to keep that at an optimal level of arousal.

But what happens when the stimulation's too high or too prolonged? It's going to short circuit. Right? So we're really interested in the development of that circuitry in the brain of young children over time because of its importance for executive function. Because of its importance for, I would say, school readiness. Right? And this follows this nice inverted U-shaped curve if you're familiar with that, right? The Yerkes-Dodson law and the idea that a little bit of stress is a good thing for complex learning, right? It's very different from simple learning. If you're conditioning a reactivity, then the idea is experience is helping the child, right? It's a supportive environment that's helping the child to regulate emotion and attention and physiology. It's helping the child learn to stay at the top of that curve. To not be too bored at that end, the far left end, or too stressed out, the far right end here. That's sort of a simple way of thinking about it, but it works. I think it's effective.

Then, of course, this prefrontal cortex is a slow developing area of the brain. So, there potentially is time for plasticity and remodeling to occur. We don't have to panic. Oh no. Right? We're age four and a half, and we can't do peg tapping. There's hope yet. Right? For most of us, I think. Then, of course, they say the prefrontal cortex is the slowest area of the brain. It doesn't reach full maturity until about age 20, 21. You know?

The brain's developing all the time. It just goes up, and then it just goes right back down is the problem for prefrontal cortex. Right? So, we're not talking about gerontology and cognitive aging, but these are some of the deficits that we experience as you get to be my age and a little older, in terms of this, the working memory problems, and those sorts of things. It's the flip side of this. So, sort of last in, first out is the idea with brain development and cognitive abilities with this. Right?

So, as I said before, they're essential for school-readiness and school-ready achievement. Right? They seem to be. We have, I think, increasingly good evidence that poverty is physiologically stressful for children. That is probably a primary mechanism for the school-readiness gap that we see. Because when kids start kindergarten, they're already behind when they come from poverty homes. So, what can we do about it? And how can we best support this system? So, it uses sort of neuro-scientifically informed approach to understand why helping kids regulate emotion and attention and physiology and a little bit of stress, learn to handle stress is a good thing.

I think there are a couple of sort of things that we can do about it. People have looked at this. Right? So, there are studies that demonstrate the effects of poverty on child stress physiology and partly through this mechanism on school-readiness. One of ours is a longitudinal study known as "The Family Life Project," which is a longitudinal study. It's called an NIH Federally Funded Program Project Grant.

It's similar to, if you're familiar with, here in Memphis, the "Candle Study". We've been following a group of families and children from birth, and they live in rural communities, small town. You can think of it in Pennsylvania and North Carolina. We started it when I was a professor there. So, we've been collecting data in the home through home visits at these time points, seven months of age through 16 months of age, measuring parenting and family ecology. My part of the projects, of course, focused on emotion and stress physiology and executive functions. We have genetic data. I won't talk any about that tonight, but the importance of these kind of studies for helping us understand development. Right? Then, I'll talk about some experimental stuff.

We always collect saliva. So, we're looking at stress hormones through saliva in the children and in the mothers, by the way. It's less talked about, but we should probably study stress in the mothers. We should probably study it in the kids' teachers as well. Teachers often volunteer to give saliva samples in the studies that we run. I haven't been able to take them up on it yet, but I plan to one of these days.

So, we're looking at cortisol in response to these sort of emotion challenges, the child's ability to regulate emotion. What we find, basically, is that when kids are in these chaotic households, sort of the stress levels are high. This is a measure of cortisol from saliva, from seven months to 48 months. That dash line is children is high chaos homes, and their stress physiology is elevated. You want to be able to turn it on. So, you want it low when you need it. But then, you want it to go away. The idea here is this concept of allostasis, it's called. It's sort of like turning the thermostat on in your house and leaving it on, because you think it might be cold. You just don't know what the weather is going to be like. But eventually, your house will burn down, but you'll be warm. That's the important thing.

Then, we looked at the extent to which of measuring parenting and measuring this cortisol and the extent to which this would go together, kids' ability to regulate emotion, their high quality parenting. Sure enough, it was related to lower cortisol levels in these children, ages seven, 15, and 24 months, and to executive function, but not to IQ. Really, I think self regulation is more important than intelligence. It's more important than IQ for a child's development, because we don't really know what IQ is to begin with, anyway. We know that it's measured well.

Self regulation. We have a much better understanding of this and where this is instantiated in the brain and how it works physiologically and all of those things. So, this was gratifying to see, to a certain extent. Then, right. I won't even... This is going to be redundant. This study, I think it made a big impression on all of us, as psychologists, this longitudinal study from Dunedin, New Zealand. So, another shout out for the value of longitudinal research, in which they found that as Professor Fox showed you before, relations between self-regulation and early childhood, and in that study, they were measuring it between really age three and age 11, but related to adult outcomes at age 32. In almost any outcome you throw in there, they're seeing this relationship. This is controlling for IQ and SES.

So, they made a number of manipulations in the data analysis. They took out the lowest. They took out the highest. They controlled for IQ. They controlled for SES. Every time, self-regulation showed up in these analyses in much the same way. Oh. Sorry. Socioeconomic status. So, poverty status. Yeah. Alright.

So, what can we do about it? Right? We see this. Can we support children's self-regulation with the idea that it's going to support brain development in healthy ways, in appropriate ways? The answer, I think, is encouragingly yes. So, there's some randomized controlled trials. This is run by a colleague at NYU. Sabell Ravor [SP] is her name. She was a professor at the University of Chicago at the time that she did this. It's called "The Chicago School-Readiness Project."

These were in head start programs in inner city Chicago that were basically just derailed by child behavior problems. That's kind of all they were doing all day long, was trying to help kids to calm down. Kids from very stressed out homes, from very, very disadvantaged homes. What the teachers needed? The teachers needed a break. They needed a mental health consultant, and they needed coaching to come into the classroom. That's what the Chicago School-Readiness Project provided. Right?

The idea would be it would improve the emotional climate of the classroom. It would lower these levels of child conflict with peers, and it would lower teacher stress. It should relate to increases in self-regulation. Kids' executive function should get better, and learning should increase. And guess what? It was a randomized controlled trial, so a true experiment with randomization at the classroom level. Sure enough, that's the effects that they found. Right? So, there were treatment effects on executive function, on a measure of attention and impulsivity, not quite there for effortful control. I won't go into all of this exactly what it is, but they're related constructs.

Also, they found effects on children's vocabulary development, their letter naming, and early math skills. Right? So, this model, this idea of ways we can support self-regulation by supporting emotion and attention should support executive function. By supporting executive function, should help with school-readiness. Sure enough, in a mediational [SP] analysis, so this path. So, the far left would be the intervention. The mediator is the executive functions, and then the outcome is the vocabulary, letter naming, and math skills. So, there's a mediated effect here that I won't go into. It's an important statistical technique that helps us understand the idea that there may be a causal relation among these variables.

Certainly, the experimental method in this is very important. We have other examples of these sorts of projects. Right? Another that is not designed specifically for the environment of poverty, but I think works, we have some evidence that it works really well with this, that's exclusively, not exclusively, intentionally focused on executive function, development, and self-regulation in children is this tools of the mind curriculum. Right? So, it's developed by two early childhood educators in Colorado, Deborah Leong and Elena Bodrova. It really focuses on executive function as a way to promote academic outcomes for kids. Right? And good social skills for kids. It's based on a Vygotskian Approach to early childhood development, if you're familiar with that.

Mainly, what it is is it's structured socio-dramatic play. So, children are planning their play. They're planning who they're going to play with, how they're going to play. They, then, enter into an extended play bout around a particular theme, in which it's high level make-believe. It's structured make-believe. That's the main ingredient. There are other aspects of the curriculum. I'm a pretty poor spokesman for it, to tell you the truth. So, you could go online and look for more of this.

I've been in the classrooms, and I was just astounded by the focus in the classroom, kids paying attention. Often, you go into an early childhood classroom. If it's not well-run, you're kind of the most interesting thing that's happened in there that day. Kids will sort of follow you around and look for you. That sort of thing never happens in Tools of the Mind. They look over their shoulder. They see that you're there. They check you out. Okay. Then, they go back to what they're doing. There's a lot of focus.

Actually, there's an interesting... President Obama was in a Tools of the Mind classroom in Washington, D.C. a couple of weeks ago. The link may still be up on CBS news. But, he's sitting there with the kids. There's the President. There's like five cameramen and security guys, and the teacher is doing a little writing lesson that they do. All of the eyes are focused on the teacher. Not a kid... I'm serious. It's just amazing. It's astounding. You'd think it was scripted, but there's not a kid looking at him or looking at the security guys or the camera. They're all focused on the... eyes on the teacher, who does a great job, by the way.

So, I think there's a lot of promise for this curriculum. There's some mixed results from these studies, though. Anyway, here's another aspect of the curriculum. These kids are doing a little math, an ordinality math lesson. They tend to do things in pairs. Right? So, one kid is the doer of the math lesson. The other kid is the checker of the kid. That's the... Many of the activities are like that, done in pairs or small groups. The idea is you don't want to necessarily have to learn both those roles at the same time. You can learn the doing of the math concept, and then learn to check it. Do them separately, and then integrate them over time. So, that's the idea behind Tools of the Mind.

There's been an evaluation of this, a small scale evaluation. My colleague at UBC, Adele Diamond. What Adele found was that there are effects on executive function development. This was a randomized design as well. In this one, she didn't have academic outcomes, but she was able to get them later and found that the more complex executive function task, which are these ones on the right, the reverse flanker and the dots mixed. I won't go into those. You can think of them as like really hard peg tapping. They saw big effects on those, kids being able to at least do the tasks. Then, that ability to do those tasks, the complex task was pretty highly correlated for the most part with academic outcomes in the kids.

Now, subsequently, another team did an evaluation of this Tools of the Mind curriculum in Nashville, at Vanderbilt. You may have heard of it. And they found no effects on preschoolers in that curriculum. We have subsequently done one with kindergarten, there's a kindergarten version of this curriculum, it's the same thing, it's play-based, but kids are going to learning centers it's a different kind of play that they're doing. It's very child directed, it's very group oriented and they're following this plan as they do it. And they play around themes. They actually play around these themes, the 'Magic Treehouse Books', if you're familiar with those books, and they have a lot of vocabulary in them.

Kids learn a lot of vocabulary through this themed play. And we we found, we found some smaller general general effects on math and reading and working memory. We found very big effects, really, in poverty schools. This was a randomized design, we randomized at the the school level that included 80 classrooms in 29 schools and about 800 children. We just completed data collection on it the other days for the first grade followup. And we saw was at the end of kindergarten, these are effects of the curriculum, in controlling for baseline availability, effects of the treatment. And were really encouraged by these findings.

And the most encouraging things we saw effects on growth and reading into the first grade. That's impressive. These are hard things to change I'm really... it's the curriculum. I think it's an exceptional curriculum. It has the right idea. It's based on executive function. We don't have the Neuroscience behind it, hopefully we can do some brain imaging, that question came up before.

And actually we've been talking to a lab, this study was in Massachusetts, so it had some very low-income schools in Linn, Massachusetts, and there's some really high income schools in the Western Part of Massachusetts. We hope to do some brain imaging through a colleague at MIT, John Gabriellie, to look at some of the effects of tools in the brain. Eventually we'll be able to that, I'm sure we'll do that.

And as well it's not necessarily exclusive to that. I don't want to focus on the curriculum, per say, but focus on the approach. Focus on self-regulation as we understand it, we know how to support it. [Montessori] in evaluation had very similar effects in... I think these are five year olds and twelve year olds. But if you get to school and you're not ready for it you just fall farther and farther behind.

So the way we need to approach this is to think about early childhood, think about parenthood, think about its effects on brain development, how best to support it, because we want good outcomes: it's the only way we can combat income inequality and inequality in our country right now: we have to make sure kids are ready for schools. We have to do everything we can. Remember Education Goal One? Back in the nineties? Every child would enter school ready to learn? That was the first Bush. We didn't make much progress on that one, but we can. It's still an important goal.

So, just to wrap up. So, just to say another way is of course to start early, and there's some parenting programs out there. The Early Headstart got very into this program got very interested in this idea of Toxic Stress. The idea that poverty is stressful for children. And what we're evaluating in this study is the extent to which a high quality parenting program in Early Headstart can reduce stress not only in the child but the mother as well. So we're measuring mom's physiology and mom's function in this study, right?

So, just to wrap up. You know, I think these community efforts, whether we're talking about agencies providing services to families or we're talking about the best way to structure education and experiences for kids can recognize multiple manifestations of risk. Physiologically, attention, emotion, and so forth. We need to clue into these to promote healthy development and now what we know about gene expression: the extent what to which what's happening in the child physiologically is influencing the expression of genes. We're not talking about the DNA sequence, we're talking about genes getting turned on and off in response to experience in ways that as develop becomes more conservative and begins to set up.

So again research suggests to focus on stress, but not that stress is inherently bad. The regulation of stress. The moderation... so let kids try things. Let kids experience failure. That's okay, you gotta deal with that and overcome it. So, in education, I'm big on this... the idea that we can remake education. We talk a lot about failed education in the United States but I think we have a very good idea, we just need the political will to follow it through.

And then finally these executive functions are dependent on self-regulation. One aspect of a SES-related achievement gap in a common pathway, through which many things effect develop, over time, right? And some more conclusions, but I just want to wrap up there, right. In that we know a lot about how to support children's development and brain development and I encourage you all to, if you have the opportunity to get involved, to do as much as you can in supporting children in your community.

And here's to my many collaborators and funders and thank you so much for having me here and your time and attention tonight. Take your time at your busy schedule on a Thursday night to come and hear about brain awareness!

Male Audience Member: Questions for Doctor Blair? In front of me?

Male Audience Member: I just had a quick question; going back to self-regulation. Is there any evidence that children who naturally self-soothe, like thumb suckers, actually do better in cognitive testing or school readiness?

Dr. Clancy Blair: That's a great question! We actually have data that addresses that, I showed it today at the earlier meeting. What we do is to scare babies and make them angry and make them cry in our research, we're 'those' people.

It's okay. They calm down.

They're not a permanently scared mess. But we what we saw is that we code for how upset the babies become and then we code for their self-soothing activities: usually avoidance and turning away. And sure enough at 15 months the highly reactive kids who showed a lot of regulation do a lot better on executive function at 48 months of age. Kids who are highly reactive and don't show any regulation do the worse.

Female Audience Member: So if we're seeing this Lymbic system that's developing really very early on and then we see the Pre-Frontal Cortex which is not really coming to full development until into the twenties, than do we focus early-on on the Lymbic System in this emotion regulation or do we focus on the connectivity between these systems without kind of stressing the Pre-Frontal Cortex to develop too soon.

Dr. Clancy Blair: That is a really good question! That... I don't know the answer. I hope that you can figure that out for us.

If you were a graduate student. If you're not I'd encourage you to become one as soon as possible.

So what we don't, I think, know as much about is the course of brain metabolism. I'd be very interested in just the amount of the energy at the brain at any one time point. I would say, from my standpoint on that, the idea is that the absolute essential thing is to provide an appropriate level of complexity for young children. Sort of a [Vedotsky] and zone approximate development sort of thing. If it's too simple kids won't pay attention, it's boring, if it's too complex it's confusing and the Pre-Frontal Cortex will shut down. I would say... yeah. It's a dual-pronged attack. Both the appropriate level of complexity and support for the Lymbic System.

But if you could only have one or the other the idea is that their compensatory response could kick in. So that would be the idea.

Male Audience Member: So I'm trying tie your talk with the previous talk. And so this concept of 'toxic stress'. It gets thrown around a lot. These are two words and they're linked together and... I don't know what it means. So is it toxic stress when it turns off the Pre-Frontal Cortex or is it toxic stress when the child sort of [de-compensates]- how would you characterize that?

Dr. Clancy Blair: It's a tricky- it's a tricky idea. I think of it in the former way. That it's when- when the stress physiology is under pressure, is under aesthetic load, and it goes to a point... could be low, but usually high... in which it's just not flexibly regulated anymore. And you need to be able to flexibly regulate it and have it track along with behavior whether than have it be divorced from behavior.

That's where I see, but this idea of 'toxic', it suggested that it... and it may be killing cells, perhaps it's doing that... but I think of it more as it's causing certain cells to fire in certain patterns that wire up in ways that are going to shape behavior towards a more reactive mode as opposed to a more reflective mode of responding. So, I don't know if that helped, it probably just helped with the confusion, but certainly that's the goal: is to make that clearer. And I think we have as a field and as spokespeople to do that.

Female Audience Member: So, going from that, is the better way to think of toxic stress is it more dependent on the persons or the child's reaction as opposed to... I think we have a kind of tendency to sort of think of certain kinds of environments to be 'toxic stress' for children as opposed to thinking about whether the threshold is different according to the child.

Dr. Clancy Blair: That's another very good question, a very good point. And I think when we use toxic stress we think of alarms going off and this craziness and chaos. But environments might just be unpredictable and too complex or not complex enough, and I would characterize that as toxic stress, too. It's not supporting children's development in a way that is toxic ultimately to a child, however we begin to define that. But that could be problems with the regulation with the attention, the regulation of emotion and so on and so forth that really undercuts the kind of goals that we would like to see with children that I listed at the outset.

Female Audience Member: Thank you.

Female Audience Member: You mentioned that you had teachers that were willing to give saliva samples.

Dr. Clancy Blair: Yes.

Female Audience Member: Do you ever have parents that might be willing to give those saliva samples.

Dr. Clancy Blair: We do...

Female Audience Member: Just thinking that children are completely dependent on their parents in that environment is certainly not going to- it's always out of control of the child. Life has taught me that parents are often the child's first and best teacher if they know what to do. But it's hard if you came from an environment that was toxic not to repeat the exact same process. So, for me, I struggle with that we can do all these wonderful things for the children but then we have to return them to the toxic, perhaps environment, that perhaps the focus could shift or include the parent.

Because in my mind as long as they're minors it's a package deal...

Dr. Clancy Blair: I agree.

Female Audience Member: And to be able to put wires, fires together, wires together. It's already wired incorrectly, if you will, in their parent.

Male Audience Member: Right.

Female Audience Member: And that's, we don't want to separate children from their parents. All those social issues. It's a big big, complex. If we could get to the parents I just feel like they could - they need to be included in almost everything. They're the success. If we want to stop the madness, if you will.

Male Audience Member: Absolutely, that's very much a priority right now. Of course, we've always as psychologists as much as possible focused on the di-ad or the tri-ad or whoever, but maybe more with lip service than not sometimes. But that's right. Measuring physiology in moms, executive function, the ability to regulate emotion and attention, they're exactly the example that children are going to be following and to complicate things, too, we really need to know inter-generationally or at least back to adverse early life experiences given the potential effects we've seen in a number of longitudinal studies that these adverse life experiences have long-term effects. So we can administer questionnaires to parents about that but we don't know. I think you make a great point almost immediately measuring those things in parents, and that's what our early Heady Start study is focused on.

Female Audience Member: Thank you.

Male Audience Member: Other questions? I had one for Dr. Fox to maybe relate to this. My question has to do with the idea of delayed development of frontal cortex - pre-frontal cortex. So what I have understood before is the long tracks mylination isn't totally complete in the long tracks to to the pre-frontal cortex until this early age. But is there imaging data from adults to verify that it's really functioning fully until, say, twenty-one, twenty-two? Is that kind of data available? When we say that it isn't really fully developed until, say, age twenty.

Male Audience Member: So you know there are - [inaudible 0:02:14:0] has done serial images - functional imaging of young children. I think he started at age three and it goes all the way up to age twenty. And he shows that changes that occur in neuronal growth and development across that period of time. I don't think it would be right to say that it's not functioning, but I do think what he does show in those studies is that there are physical changes that are occurring up through age twenty, mostly having to do with pruning. It really has to do with the later changes, the later changes having to do with cortical thinning as opposed to the elaboration of connections and synapses.

Male Audience Member: Thank you.

Male Audience Member: I have a question for -

Male Audience Member: Okay, Paul.

Male Audience Member: Both Dr. Fox and Dr. Blair. 3-8-1-2-6 is one of the poorest areas in Memphis and one of the poorest areas in the country and if I could go over there get their, the parents attention to tell them three things. How would you prioritize what I should tell them? Male Audience Member: Well, I would say the first one for me would be language, language, language. Speak in a lot of positives, and minimize the negatives. Speak, speak, speak. Sing, sing. Speak. Just get that constant stream of language up to your baby even though your baby doesn't understand what you're saying. Your baby understands what you're saying. So that would be number one for me.

Male Audience Member: Let me ask you to expand your question. So if I say three things to a parent, do you mean a parent of a new infant or the parent of children? Because I think both the demands of care, the demands of parenting change as kids develop, right? So it's a different thing that I would say to a parent of a one year old than I would say to the parent of a four year old.

Male Audience Member: New infants. Yes, right. To protect the child from the stress of poverty.

Male Audience Member: That's a tough...

Male Audience Member: I would say the language definitely. A lot of talking, a lot of reading to the baby. A lot of talking to the baby. A lot of language stimulation.

Male Audience Member: And I would say new baby, serve and return. Right? So I think contingent, responsive social interaction in a positive way is the most important thing in the first year of life for a baby.

Male Audience Member: Right and I would say attend to your baby's cues. So where your baby is looking or when your baby's upset, try and...you'll need some education to go along with that but attending those cues. What are they? And then give some examples of those. I think that's really important. And then, it's a borrowed line from a woman named Mary Dozier who has attachment focused intervention. One of the watch words for her intervention is don't scare your baby.

Male Audience Member: What did you guys do to your [inaudible].

Male Audience Member: Thank you, Hank. I served you that as a softball and you hit it. Yes. So that idea, too. But be very responsive to serve and return.

Male Audience Member: Can I be as bold to suggest number three? Is touching the baby. A lot of tactile stimulation. Because they need to form a body image. And I think a lot of the differences we see in the Eastern versus Western psychological development is from daily massages and things. And there may be a biological role because nerve growth factor is manufactured in the skin and it goes up the efferent nerves into the brain. I mean, maybe the third thing is stroke, touch, gentle as your baby as much as you can.

Male Audience Member: And if I could say one other thing. If it were possible for the parents, for the moms, for the dads to create the conditions that would reduce their stress. That would be as important, not more important, abut as important for all the things they could do with their baby.

Female Audience Member: I was just going to say this is one of our newer publications that we have for agencies and families and this is the distilled message that we have come up with which is not to dismiss anything y'all just said but we also believe it's important to communicate things really quickly and solidly without too much jargon in language which is hard to do in our professions that we work in. Anyway, I just wanted to plug this because we've been working on this for this idea for getting the idea out about touch, talk, read, play for a number of years and we feel like it's getting some traction. I don't know if any of y'all have heard of it already but - anyway, thank you.

Male Audience Member: Thanks.

Male Audience Member: We have one more, we can take one more. Go ahead. Paul, right over here.

Female Audience Member: Hi. I'm a parent of a five year old developmental delayed child. Also, I'm a Head Start teacher as well. So assume I can wear two hats in one. What I noticed in my child that's developmentally delayed is the age of three and I tried to get her intervention services, they denied her. They stated that it was too late. Due to a prior that I'm already childhood education field, I'm also in school for my bachelor's in early-childhood education with a minor in special-ed. I do the language, I do all the positives. The everything.
Right now she's in the public school system with an I.E.P for autism, ADHD, sensory integration, the list goes on and on and on. She has several therapists. The neurologist, he wants the consent to give her four different types of medicine. My problem is how can she learn or grow if she's constant medicated? What can I do to improve her status? It's hard to find her a school that will meet her needs.
I'm having problems with the teacher in the special-ed pre-K. I get calls. So it's like I said, I'm wearing two hats in one because I'm a Head Start teacher as well so I deal with twenty personalities. I deal with developmental delays. I deal with behaviors. I'm trying to get as much help for my child and someone else's children as well.

Male Audience Member: I mean I wish I had some good advice or solid advice for you or help with that but I think it's the same sort of things that you want to do in terms of touch, talk, read, play. And I know that can be more difficult and to find ways to do that. But I think that's the understanding of developmental delay is it's delay. Right? It's a slower process. It's going to maybe never get to the exact same place that it would have been otherwise but there's a developmental progression and development is so important and certainly we know that. And I think focusing on aspects of the same sorts of things and finding different ways to do that, perhaps. I wish I had more advice for you on that, but I think it sounds like you are doing those things and will continue to do them.

Female Audience Member: I just wanted to say please don't leave out music. Because that is so wonderful for children. And what you were talking about...finding a record player, CD player for children in underprivileged homes and some wonderful children's tapes in verbal as well as musical can go such a long way and it also soothes children.

Male Audience Member: Yeah.

Female Audience Member: It stimulates them and soothes them.
Male Audience Member: Well you read my mind on that one, that was the next thing I was going to suggest. We're doing a little project with a Jazz musician. He works with preschoolers in terms of teaching them just simple rudiments of tempo, dynamics, sound, being in control of sound is a great thing and it's a very simple but fun and enjoyable activity that children can take control of. So that might be something to think about for sure.